'Valè' nan swen sante - ki deside?

By Ewopeyen Alliance pou Medsin Personalize (EAPM) Direktè Egzekitif Denis Horgan 

The differing ideas about what constitutes ‘value’ in modern medicine is a hot topic for debate in Europe and beyond.

How do we define it? How do we measure a human life – or quality of life - against the cost of a treatment? Do we judge the individual’s contribution, fiscally and otherwise, to society and weigh it against a price? What about the moral issues involved in such judgments? And who would want to make them?

Consider an equation such as this  - ‘Mr A will pay x in taxes if we treat him, he survives and he then goes back to work. But the treatment costs y. Let’s do the maths…’

Pifò nan nou ta jwenn ke chokan, enjis ak brutal. Men, li k ap pase nan yon sans laj.

Unfortunately, with an aging population of 500 million citizens, health care in the EU has never been more expensive. People are living longer and will, in most cases, be treated for not just one but several ailments during their lifetime. It’s a dilemma, and it won’t go away.

Pou konprann 'valè' youn dwe premye, nan kou, konprann yon tretman, plis nenpòt ki lòt chwa tretman, ak konsidere ki sa li (oswa yo) ka bay.

reklam

Pasyan, lè yo konprann opsyon yo, yo pral gen opinyon pwòp yo sou sa ki konstitiye valè, tou depann de sitiyasyon yo  - “Will I get better? Will I live longer? Will my quality of life improve? What are the side effects?”. `

Peyè yo, pa etonan, lè yo peze, menm jan yo fè, benefis kont pri ak lòt konsiderasyon, ka pran yon apwòch diferan.

Pandan se tan, manifaktirè yo ak innovateurs yo dwe opere nan limit nan "valè" ki poko klè.

There is a solid argument that value should always be defined in respect of the customer, Value in health care depends on results and outcomes – vital to the patient - kèlkeswa volim nan sèvis lage, men valè a se toujou ale nan dwe wè sa tankou relatif nan koute.

So, are expensive medicines and treatments ‘worth it’? Let us take two specific examples. First, new drugs to treat the hepatitis C virus (HCV) may beat the epidemic. But their cost is high and beyond many patients.

The World Health Organization tells us that 350,000 people die each year from the 150 million chronically infected with HCV and the new direct-acting antivirals could halt the global spread of infection. So, if health-care systems supply the drugs, is that value? You decide…

Second, up-to-the-minute cancer treatments can now treat some of the most severe or rarest diseases known to man. Over the past two-and-a-half decades, cancer patient life expectancy has risen by some three years, with four-fifths of that figure directly down to new treatments and medicines.

These drugs and treatments are expensive. But are they worth it? Again, you decide…

Yes, money is a huge factor. Yet Europe should make no mistake about the correlation between wealth and health. Studies – at least one conducted on behalf of the EU executive itself - have repeatedly shown that benefis ki genyen nan sante piblik amelyore pi lwen pase tou senpleman diminye depans swen sante. Reyalite yo se sa better health makes a positive contribution to the productivity of citizens.

Meanwhile, less hospital beds are used up, people tend to work longer before retiring when they are healthier, citizens are more productive when healthy and often work longer hours, and there are less sick days taken. That’s certainly one idea of ‘value’.

Personalised health care is a rapidly growing field that aims to provide the right treatment to the right patient at the right time. The European Alliance for Personalised Medicine (EAPM) has worked with its membership to engage patients, payers, policymakers, academia, and industry to examine various approaches to value assessment.

A 25 February workshop in the value of, in this case, companion diagnostics - will showcase the different views – including those from an EAPM cross-stakeholder survey - with the objective of hosting a critical discussion.

Europe’s – and the world’s – ongoing debate on the meaning of ‘value’ in health care needs to be concluded soon, for the benefit of this generation of patients and the many more that will follow.

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